When and where to refer your patient

Timely referral is critical in managing facial palsy effectively.

This guide outlines key timeframes and clinical indicators for when referral to a specialist is appropriate. It also provides guidance on which services are best suited to support diagnosis, protect function (particularly eye health), and explore surgical or rehabilitative options when recovery is incomplete. Use this as a quick reference to ensure your patients receive the right care at the right time.

Timeframe Indication Rationale Who to?
Immediately Red flag symptoms Other cause likely Neurology, ENT or plastics
Immediately Concerns about eye Eye protection Ophthalmology or plastics
3 weeks after onset No improvement in facial movements Need to exclude alternative cause Neurology, ENT or plastics
3 months after onset Incomplete resolution May benefit from early surgical reanimation procedures Plastics

The red flag symptoms to look out for include:

  • Gradual onset (>48hours)
  • Parotid or neck mass
  • Recurrent or bilateral facial palsy
  • Vesicular rash
  • Forehead sparing
  • Additional neurological signs
  • Associated persistent unilateral hearing loss
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